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Orthodontics For Kids ·

Discover bespoke orthodontics for children at Smiles Pediatric Dentistry & Orthodontics in Los Angeles! The Smiles vision smoothly combines pediatric dental and orthodontic services simultaneously. This game-changing setup ensures efficient appointments for your children and enhances comfort for the entire family.

Orthodontics for kids involves more than just moving teeth. It includes dentofacial orthopedics, a term that translates to simultaneously guided dentition growth and facial bone growth. This early phase of orthodontics is the first of two phases of orthodontic care and starts when kids are well under 10 years of age. A big benefit to phase one orthodontics is that we can utilize the primary molars as appliance supports. Appliances for phase one orthodontics include palatal expanders and early clear aligners.

Interwoven Pediatric Dental and Orthodontic Care:

At Smiles, we understand how busy life can get. This is why we created a dental home that seamlessly encompasses all aspects of your child’s dental health and wellbeing. This vision took a decade to build and stemmed from the core belief of the unparalleled benefits of interwoven, comprehensive collaboration between the disciplines of pediatric dental care, growth and development, dentofacial orthopedics and orthodontics.

The Smiles Dental Team United:

Elevated in-house collaboration between the Smiles Team members, from doctors to dual-certified care coordinators has many wonderful benefits:

A comprehensive “think tank” approach for your child’s dental well-being map.
Tailored visits that are customized to your child’s specific dental and orthodontic needs.
Efficiently combined pediatric dental and orthodontic visits that value your family’s time and yield excellent results.
Collaboration that fosters a bond of trust between your child and the Smiles Team.

Early Orthodontics/Phase I Orthodontics:

Orthodontic issues that are addressed early allow the return of harmony and balance to developing smiles. The American Association of Orthodontics (AAO) recommends that all children be screened by an orthodontist for orthodontic needs around age 7. By this age, most children have a few permanent teeth sprouting in their mouths. Early Orthodontics usually happens between the ages of 6-10 and aims to correct early malocclusions and guide newly erupted teeth into favorable positions.

Part of every visit at Smiles includes an orthodontic evaluation. We will be tracking your child’s growth and letting you know when it is time to start considering early orthodontics. What makes our approach unique is that we already know your child and they know and trust us. Rather than meeting new faces for their orthodontic care, they will be cared for by the trusted team that they’ve known from their toddlerhood days in streamlined, efficient and collaborative visits.

Readiness For Phase I Orthodontics:

An important assessment of each child’s readiness for orthodontics is their level of maturity and comfort in the dental setting. Our “whole-istic” approach to dental well-being allows us to hold their hand (and yours!) through this process. For some kids, we can start placing orthodontic appliances as early as 6 years old or younger. For others, we may need to wait a bit until they are able to handle taking care of an appliance. With a successful and joyful outcome in mind, we will team up with you to find the “sweet spot” to start each orthodontic adventure.

Goals Of Phase I Orthodontics:

Early Orthodontics aims to promote proper dentofacial development and enhance the growth potential of both the upper and lower dental arches. Because the facial bones and teeth are in active growth, gentle guidance can help create a very favorable outcome for the eruption of present and future permanent teeth. Here are the goals of phase I orthodontic treatment:

Correct positions of misaligned permanent incisors
Correct and promote functional occlusion
Beautifully shape growing faces with dentofacial orthopedics
Define the dental arches and prepare for further permanent tooth eruption

Conditions that benefit from Phase I Orthodontics:

Underbites: When the bottom front teeth are in front of the top front teeth.
Crossbites: When the top teeth are behind the bottom front teeth.
Functional shifts: When the lower jaw is forced to move sideways due to teeth hitting each other causing tooth and jaw changes.
Crowding: Overlapped teeth.
Extra or missing teeth causing shifting and arch distortion.
Bite changes due to oral habits like thumb sucking, finger sucking and tongue thrusting
Open bites due to aberrant tongue positions.

Digital Imaging Suite:

State-of-the-art technology is the hallmark of Smiles! Our orthodontic workflows are completely digital, boasting the Itero/Lumina and Dexis oral scanners. From digital photography to intraoral sensors, to hand-held imaging technology and the ultra progressive Dexis OP 3D unit, our office is equipped with a digital imaging suite that covers all aspects of pediatric dental, orthodontic, and esthetic imaging needs.

Treatment options In Phase I Orthodontics:

3D Printed Metal Fixed Palatal Expander:

An expander with a metal frame and resin pads that can be created in rainbow color choices. This expander is cemented onto the dentition. We prefer placing it on the second primary molars that will eventually be replaced when possible. The device is activated with a small key that is inserted into the expansion screw that separates the resin pads. This appliance gets the job done and kids love to choose its color and show it off!

Invisalign Palatal Expander:

Invisalign’s latest solution to increase arch width with a series of printed appliances that are switched out daily or every other day. The approach is a fantastic one in terms of ease, ability to clean and sure results!

Clear aligners:

Early aligners for younger ages that magically move newly erupted teeth into perfect alignment setting the stage for an easy second phase of orthodontics in the teenage years. Aligners are removable making it easy for kids to brush and floss while achieving excellent orthodontic results. Invisalign First aligners are designed to treat a wide spectrum of orthodontic issues as kids grow and develop.

Traditional Braces:

Metal braces are a quick and sure solution to align newly erupted teeth after the arch from has been established with good expansion. Rainbow colors are available for all ties. The sky’s the limit!

Ceramic Braces:

As an alternative to traditional metal brackets, clear or ceramic brackets offer a metal-free option while keeping the rainbow color choices for elastic ties.

Removable Appliances:

These appliances come in rainbow color choices and can be great solutions to a many orthodontic situations. They need to be kept clean by brushing with a toothbrush and placed in their box when they are not being worn.

Reverse Pull Head Gear (RPHG):

An orthopedic appliance that helps move the upper jaw forward when it is positioned further back than the lower jaw causing an underbite. The appliance rests comfortably on the chin and the forehead and uses orthodontic rubber bands to help with the traction movement.

Retainers:

Appliances that maintain the improvements in the arch form after treatment is completed. These can be acrylic appliances or 3D printed clear retainers.

Printed Metal Palatal Expanders ·

Printed Metal Palatal Expanders Explained:

A printed metal palatal expander is a custom-made orthodontic appliance designed to widen the upper jaw (or palate) over time. It is fabricate by 3D metal printing from a digital impression to ensure an impeccable fit. This type of expander is bonded onto the teeth and works by applying gentle pressure to the midline suture of the palate of the upper jaw as the appliance is activated. This generated pressure gradually encourages bone growth in the middle of the palate which, in turn, creates more space to align the teeth. We add acrylic pads to the metal framework of our expanders. This allows the appliance to be both tooth and tissue supported and equalizes the delivered pressures onto wider surfaces.

Timing For Fixed Expanders:

Taking advantage of the ongoing growth potential in younger children is essential for achieving excellent orthodontic results. Most expanders are placed by by an orthodontist when kids are in mixed dentition (once a few permanent teeth have emerged but many primary teeth are still in the mouth). However, if the goal of the expander is to correct a posterior cross bite and/or a functional shift, the earlier the treatment starts, the better. This, of course, will depend on the comfort levels of each child and family. For very cooperative kids, appliances can be placed as young as three years of age and will certainly help to redirect and harmonize dentofacial growth.

Fabrication Of A Printed Metal Palatal Expander:

To fabricate a custom appliance, we will need digital orthodontic records: 3D digital imaging, photography and a digital impression or oral scan. With our state-of-the-art oral scanners by Itero/Lumina and Dexis, oral scans are simple and comfortable. Once we have the data files, these are securely sent to the lab to begin the process of creating the expander.

Placement Of A Fixed Expander:

Printed Metal Palatal Expanders are bonded onto the dentition with orthodontic bonding cement using the following steps:

The fit of the appliance is verified
The teeth are cleaned with a professional dental prophylaxis paste and prepared to receive the appliance
The appliance is prepared with orthodontic bonding cement and placed on the teeth
The cement is light-cured and set
Instructions for activations and cleansing are discussed

Fixed Expansion Rate:

There are several approaches to the rate of expansion activations. The expansion rate can certainly be adjusted depending on the specific needs of each child. In general, rapid expansion refers to accelerated daily activations compared to slow expansion, which can be one turn a week. Each turn of the expansion screw translates to about one quarter of a millimeter of distance. Four turns will equate to one millimeter. Studies have looked at the potential changes in the midline suture of the palate and the specific alternations that can occur depending on varying expansion rates. More frequent turns at a faster pace deliver more orthodontic forces and achieve faster results but don’t always allow the body to recoup as comfortably as slower turns. We tailor our activation rates to the specifics of every child and each case and follow a semi rapid approach that is effective while being kind on the body.

Dr. Ivy Smiles Pediatric Dentistry and Orthodontics

Fixed Expansion Timeline:

The active phase of expansion is relatively fast with most activations concluding within 4-8 weeks. The length of time the appliance is activated will depend on the amount of expansion that we set out to achieve. The expansion goal is set at the very beginning of the orthodontic treatment planning and is based on measurements that are completed on the digital impression. The changes that occur in the midline palatal suture take some time to become stable. This means that an appliance must be in place passively to allow for healing to occur once the activations of the appliance are completed. Leaving the expander in place for several weeks or months after the activation period will ensure success. Most expander treatments are completed within 6-9 months.

Oral Hygiene During Fixed Expansion:

Maintaining excellent oral hygiene with diligent brushing and flossing is super important during the active and passive stages of a fixed palatal expander. Because of the acrylic pads sitting against the palate, it is also important to use a WaterPik unit to allow water to clean food debris from around and under these pads. We provide our clients with care packages that contains all the necessary oral hygiene tools needed to maintain oral health.

Food, Snacks and Fixed Expanders:

Kids can continue to enjoy most of their favorite foods when their fixed palatal expander is in place. However, with the goal of a smooth and successful orthodontic outcome, there are some foods that are best avoided during treatment with a fixed palatal expander. These include sticky/chewy candy (because it can pull the appliance out of place) and nuts/popcorn (because pieces can get stuck under the acrylic pads).

Office Visits During Fixed Expander Therapy:

After the expander is delivered, A two week visit usually follows to ensure that the expansion process is going smoothly. After this time, visits will likely be on a 1-3 month basis and can be combined with routine dental visits. Our dual-trained team will be simultaneously checking orthodontic and pediatric dental needs ensuring efficiency for the entire family.

Post Expansion Period:

Once the expander has successfully created the desired expansion and has remained in place for a few months after the activations to ensure stability of the changes, kids are transitioned into a removable appliance, clear aligners or a retainer. These appliances will continue to improve the arch form and occlusal relationship in addition to maintaining the beautifully achieved results.

Invisalign Palatal Expanders (IPE) ·

Invisalign Palatal Expander Explained:

The Invisalign Palatal Expander or IPE is a new evolution of the concept of a removable expansion device. The design of the appliance is based on digital technology and CAD software. This appliance is very different from the removable expansion appliances that we’ve known for decades in that it actually has the ability to open the midline palatal suture. Traditional removable expansion appliances are only capable of tipping teeth. Early studies completed in Canada demonstrated the fact that the midline suture responds in a similar way to how it reacts when a fixed metal expander is placed. The IPE is not one device but rather a series of devices that are switched out at a rate mimicking the activations of the expansion screw on a fixed metal expander.

Invisalign Expander for Teen Orthodontic Care

Timing For IPE:

Most IPE treatments take place when kids are in mixed dentition (once a few permanent teeth have emerged but many primary or baby teeth are still in the mouth). The Invisalign Palatal Expander usually requires primary and permanent posterior teeth/molars to be in place for fabrication.

Fabrication Of An Invisalign Palatal Expander:

To fabricate an IPE, we will need digital orthodontic records. These include 3D digital imaging, photography and a digital impression or oral scan. With our state-of-the-art oral scanners by Itero/Lumina and Dexis, oral scans are simple and comfortable. Once we have the data files, these are securely sent to Invisalign to being fabrication.

Placement Of An Invisalign Palatal Expander:

The IPE requires four small, tooth-colored attachments to be bonded on the outside surfaces of the molars. These attachments allow the expanders to “clip” into place in the mouth. The attachments are easy to place and are polished off after the expansion treatment is completed. The placement is completed with the following steps:

The fit of the first appliance is verified

The teeth are cleaned with a professional dental prophylaxis paste and prepared to receive the four tooth-colored attachments. Two on the right side and two on the left.

The attachments are created by filling small wells on the clear placement tray with a composite dental restorative material.

The clear placement tray is then placed in the mouth, the composite is light-cured and the tray is removed leavening the attachments bonded onto the tooth surfaces.

The first expander is clipped in place

Instructions for switching trays and cleansing are discussed

Invisalign Palatal Expander Progression Rate:

The switching out of Invisalign expanders is recommended on a 24-72 hour basis. The rate of switching expanders can certainly be adjusted depending on the specific needs of each child. Switching from one expander to the next is equal to completing one activation turn of a fixed palatal expander and translates to about one quarter of a millimeter of distance. Using four expanders will equate to one millimeter of expansion. Because this appliance is removable, it is essential that it is worn all day for it to work. The recommended wear time is 22 out of 24 hours a day.

Invisalign Palatal Expander Timeline:

The active phase of expansion is relatively fast with most treatments concluding within 4-8 weeks. The number of expanders used depends on the expansion goal which is set at the very beginning of the orthodontic treatment planning and is based on measurements that are completed on the digital impression. The changes that occur in the midline palatal suture take some time to become stable. This means that a holding appliance must be in place passively to allow for healing to occur once the active expansion phase of treatment is completed. The holder is an appliance that resembles that expander. Leaving the holder in place for several weeks or months after the activation period will ensure success. Most expander treatments are completed within 6-9 months.

Oral Hygiene With The Invisalign Palatal Expander:

Maintaining excellent oral hygiene with diligent brushing and flossing is super important during the active and passive stages of Invisalign palatal expander treatment. A wonderful aspect of the IPE is that it is removable, so cleaning is no different than having no appliance at all. The maintenance on the IPE expanders is easy. They are to be brushed with a toothbrush and rinsed with water and placed in the mouth after the teeth are brushed and flossed.

Food, Snacks And The Invisalign Palatal Expander:

Kids can continue to enjoy all of their favorite foods when in treatment with the Invisalign palatal expander. Eating with the appliance is encouraged to ensure that it is worn all day. There are no food limitations with the IPE. However, it is recommended to remove it and clean the teeth well after eating with it then placing it back in the mouth.

Post Expansion Period:

Clear Aligners For Kids ·

Clear Aligners For Kids Explained:

Clear aligners for kids are a modern approach to orthodontics that involves wearing a series of clear plastic trays or aligners that apply gradual and controlled pressure to the teeth. Each aligner sequentially moves teeth in desired movements to achieve an esthetic smile.

Benefits Of Clear Aligners For Kids:

Virtually Invisible Braces: Custom-made, clear plastic trays that fit snugly over teeth.
Removable & Convenient: Kids can take aligners out for eating, brushing, and special occasions
Comfortable Fit: No wires or brackets, reducing irritation and discomfort
Can be combined with elastics to achieve similar results to fixed braces
Easier Oral Hygiene: No food restrictions plus normal brushing and flossing
Fewer Office Visits: Less need for emergency appointments.
Predictable Results: Advanced digital planning ensures a clear path to a beautiful and healthy smile

Timing For Clear Aligners For Kids:

Early Clear Aligner therapy happens when kids are in mixed dentition (once a few permanent teeth have emerged but many primary or baby teeth are still in the mouth). This timing allows amazing guidance for the eruption of the developing permanent dentition. Space is created as teeth begin to emerge in the mouth at a time when growth is occurring at it’s peak. Results are magical!

Length of Clear Aligner Treatment For Kids:

Treatment length varies between 3 to 12 months, depending on the complexity of each case
Consistent Wear Matters: Aligners should be worn 20-22 hours per day for best results
Can Be Faster Than Braces: For mild to moderate cases, clear aligners can be as fast, or faster, than traditional braces
Lost or Damaged Aligners are not a problem. Replacements are available, but consistent use prevents delays

Timeline of Clear Aligner Therapy For Kids:

The timeline for clear aligner therapy is estimated before the treatment begins. The digital design and setup during the treatment planning phase will generate a number of aligners. Considering that each aligner is typically worn for 5-7 days, the number of planned aligners will translate to the expected duration of orthodontic treatment. For example, if a case is treatment planned for 40 aligners, the treatment timeline is estimated to be about 7-9 months long for the first round of aligners.

Some cases will require a second round of aligners. These are called refinement aligners and ensure that all the predicted movements are fully expressed and achieved. Refinement aligners will add on a few more weeks of treatment time. We like to give an estimate that is as accurate as possible to our kids and families. This way, we can all keep cheering until the finish line celebration!

Invis Orthodontic Treatment Dentistry for Kids Los Angeles

Fabrication Of Clear Aligners For Kids:

To fabricate clear aligners, we will need digital orthodontic records which include 3D digital imaging, photography and a digital impression or oral scan. With our state-of-the-art oral scanners by Itero/Lumina and Dexis, oral scans are simple and comfortable. Once we have the data files, these are securely sent to the lab to begin the process of creating the custom aligners.

Placement Of A Clear Aligners For Kids:

The placement of aligners requires small, tooth-colored attachments to be bonded on the outside surfaces of the molars and specific teeth needing facilitation in movement. These attachments allow the aligners to “clip” into place in the mouth. The attachments are easy to place and are polished off after treatment concludes. The placement is completed with the following steps:

The fit of the first aligner is verified

The teeth are cleaned with a professional dental prophylaxis paste and prepared to receive the tooth-colored attachments

The attachments are created by filling small wells on the clear placement tray with a composite dental restorative material

The clear placement tray is then placed in the mouth, the composite is light-cured and the tray is removed leavening the attachments bonded onto the tooth surfaces

The first aligner is seated in the mouth

Instructions for switching aligners and cleansing are discussed

Oral Hygiene With Clear Aligners For kids:

Maintaining excellent oral hygiene with diligent brushing and flossing is super important during the active and passive stages of clear aligner therapy. A wonderful aspect of clear aligners is that they are removable, so cleaning is no different than having no appliance at all. Aligners are rinsed with water and placed in the mouth after teeth are brushed and flossed.

Food, Snacks And Clear Aligners For Kids:

Kids can continue to enjoy all of their favorite foods when in treatment with clear aligners. However, we do ask that super hard, sticky and chewy foods be avoided to protect the attachment for fracturing or debonding. The aligners must be removed for eating. We recommended brushing and flossing before placing the aligners back in the mouth when kids are at home. Otherwise, rinsing well with water to remove food debris is needed prior to placing aligners back in the mouth.

Office Visits During Clear Aligner Therapy For Kids:

After the first set of aligners is delivered, A two week visit usually follows to ensure that the process is going smoothly and the aligners are fitting well. After this time, visits will likely be on a 1-3 month basis and can be combined with routine dental visits. Our dual-trained team will be simultaneously checking orthodontic and pediatric dental needs ensuring efficiency for the entire family.

Orthodontic Appliances Advanced Solutions for Teens

Post Treatment Period:

Once clear aligner therapy is successfully completed, retaining the achieved results is necessary. This can be completed with 3D printed retainers that resemble the aligners for a seamless transition. Monitoring for retainer fit and phase II orthodontic needs will continue as more permanent teeth emerge in the mouth.

The Smiles Steps To Starting Phase I Orthodontics:

Hover or tap to reveal steps

An enlightened consultation: “Whole-istic” readiness for phase I orthodontics is checked at every routine dental visit that your child has with our team. This readiness will include your child’s dental, orthopedic and emotional development stages along with your personal input on how you feel about embarking on the orthodontic adventure.

Digital orthodontic records: Utilizing our in-house Digital Imaging Suite, full photographic and radiographic records can be completed in one efficient appointment.

Goal setting and treatment mapping: With mindful understanding of your child’s dental and orthodontic needs, we will map out “steps to success” and a clear timeline for tracking alignment and ensuring healthy results. Solutions and options are discussed so that the whole family is comfortably set for success.

Delivery of the orthodontic appliance: Digital technology allows for an accurate fit and an easy delivery. During this visit we cover all aspects of appliance care and follow up so that we can support your family and cheer your child on!

FAQs

What are the benefits for early orthodontic treatment?

The benefits of Phase I Orthodontics are unparalleled. In fact, the current trend in orthodontics is shifting to achieve more care in the early phase than in the second phase, when kids are in their teenage years. There is tremendous benefit to early orthodontic intervention in terms of guiding arch architecture and ensuring proper eruption paths of permanent dentition. This is an investment in dental well-being that you won’t want your child to miss out on. Although Phase I Orthodontics is typically completed in one year of time, it is a very impactful course of orthodontic treatment.

Does my child really need early orthodontics?

Many parents ask if their child can complete orthodontic care in one phase when they are in their teenage years. This is possible for kids who have very mild orthodontic needs. For most kids, the benefit of early orthodontic intervention is extremely valuable. While orthodontics can certainly happen at any age, the power of growth slows down as kids mature. We have a much better chance of creating space, promoting proper alignment of the teeth and jaws and enhancing beautiful smiles with early treatment. Also worth noting is that the goal is to keep kids motivated and focused on their oral and dental health with short, targeted phases of orthodontic care rather than long stretches of care that can be exhausting to kids and trying on the teeth and gums. The two-phase approach to care allows a period of resting, resetting and growth avoiding gum disease and tooth decay.

What is the best time to start early orthodontics?

Early or phase I orthodontics usually starts between the age of 7 and 9. However, in some cases like underbites, treatment can start as early as the child allows, even if they are still in their primary dentition.

How will my young child handle having an appliance in their mouth?

Everything new takes a bit of getting used to. Orthodontic appliances are no different.Thankfully, the majority of kids get used to their appliances very quickly. Some Slight changes in speech can be noted for a short period of time, but the appliance won’t create a speech problem that wasn’t there to begin with. Of course, your child will benefit from your guidance and follow up with oral hygiene.

What is a Palatal Expander?

A Palatal Expander is an orthodontic appliance used to create more space in the upper jaw by opening the midline suture in the middle of the palate. The mechanism with which this happens is by applying equal pressure to both sides of the maxillla, or upper jaw enhancing the width of the dental arch. When kids are under 10, it is very simple to achieve quite a bit of expansion easily and quickly. As children grow into their teenage years, the suture matures and becomes a lot more challenging to expand. Expanders can be fixed or removable.

How many types of expanders are there?

Maxillary expanders are devices that have been around for a long while. Their designs are various and their names come from a combination of their inventors, function and structural design. They all work by applying varying degrees of pressure to the upper jaw suture/bones and teeth and the goal of their use is to increase arch width, improve arch from, arch coupling and resolve dental crowding.

Expanders named after their inventors include: The Haas fixed expander, the Schwartz removable appliance, the Alf (Advanced Light wire Functional) appliance and the Crozat appliance. Expanders named after their function include: RME (Rapid Palatal Expander), and the BioBlock and Myobrace, which are appliances that focus on expansion through muscle training and myofunctional therapy.

What is a reverse pull headgear?

A reverse pull headgear is an orthodontic appliance that helps to correct an “underbite”, a situation where the lower front teeth are further forward than the upper front teeth. This device can gently pull the upper jaw forward (using elastic traction) and help it grow correctly. The design of the appliance has a frame-like structure with rests on the chin and forehead. It typically goes hand in hand with a metal expander that has hooks in it’s design. The two devices are connected with small orthodontic rubber bands. A reverse pull headgear is usually worn all night in addition to any hours of the day spent at Home. Kids do very well with this appliance when they are young and the correction of the bite is impressive.

What is clear aligner therapy like in Early Orthodontics?

Young children do very well with aligner therapy! Many parents worry that their child will lose their aligners but if this happens, they can simply move on the the next aligner in the series! Invisalign First is a fantastic method to address early orthodontic challenges easily and effectively. The workflow is completely digital making the process easy for our young clients. Once the aligners are fabricated, we will need a delivery visit to bond on the small, tooth-colored buttons (called attachments) that help keep the appliances in place. After that, the kids sequence through the series of aligners at a rate of one new set every week. The smile transformations are magical!

How are metal or clear braces used in Early Orthodontics?

During Early Orthodontics, select teeth are bonded with fixed brackets to achieve desired alignment. At Smiles, we like using primary teeth for anchorage whenever possible. This way the burden on the permanent teeth is lessened. We are also very mindful about teaching children and parents how to clean around fixed braces to avoid plaque accumulation and to keep the teeth and surrounding tissues healthy and sound during treatment and after.